Building Recovery: The role of Payment by Results Marcus Roberts Director of Policy and Membership, DrugScope
A couple of provisional points PbR has been around for a while, but we are now entering uncharted territory Paying by results is not necessarily the same thing as payment by results Payment by results does not necessarily involve paying by results
Building Recovery … We will create a recovery system that focuses not only on getting people into treatment and meeting process-driven targets, but getting them into full recovery and off drugs and alcohol for good. (Medically-assisted recovery can, and does, happen) Drug Strategy 2010
Radical public service reform … increasing diversity of provision in public services through further use of payment by results, removing barriers to greater independent provision, and supporting communities, citizens and volunteers to play a bigger role in shaping and providing services the government will pay and tender for more services by results rather than be a default provider of services Spending Review 2010
Building recovery PLUS A radical programme of public service Reform EQUALS Drug recovery PBR Pilots
What is the intended role? Role 1: To provide financial incentives to providers to deliver recovery Role 2: To allow for providers to develop creative and innovative approaches (the how), with the Governments role restricted to specifying the outcomes (the aim) Role 3: To create a more open market to drive innovation with a greater role for independent providers (voluntary and community sector and private sector)
The domains of recovery Free of drug/s of dependence (planned exit from treatment without representation – NDTMS) Reduced offending or continued non-offending (for those without history of offending) Employment (sustained employment or full-time education – rate of people moving off benefits) Health and well-being (to reflect stakeholder feedback on the need to ensure harm reduction gains are maintained and to reflect more holistic progress towards recovery – TOPs?) INTERIM Housing? Families and carers? Service users outcomes?
Opportunities/challenges going forward 1: Incentives … without perversity 2: Harnessing the VCS … not harming 3: Local innovation … but universal standards 4: Investment in recovery … not disinvestment 5: Simple intuitive theory … but complex reality
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